The effects of sodium pyruvate Ringer solution on hemodynamic and organ functions during shock stage in dogs with a 50％ total body surface area full-thickness burn
10.3760/cma.j.issn.2095-4352.2014.04.009
- VernacularTitle:丙酮酸钠林格液对50％总体表面积烧伤休克犬静脉补液时血流动力学和器官功能的影响
- Author:
Xiangxi MENG
;
Juan LI
;
Xiaodong BAI
;
Sen HU
;
Zhiyong SHENG
- Publication Type:Journal Article
- Keywords:
Burn;
Intravenous resuscitation;
Pyruvic acid;
Hemodynamics;
Organ Function
- From:Chinese Critical Care Medicine
2014;26(4):244-248
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effect of intravenous resuscitation with sodium pyruvate (Pyr) Ringer solution against lactated Ringer solution on hemodynamic and organ functions during shock stage in dogs with burn.Methods 28 Beagle dogs were subjected to 50％ total body surface area (TBSA) burn,and they were divided into three groups:burn injury without fluid resuscitation (N R,n =8),Ringer lactate solution(RL,n =10),and Pyr Ringer solution (RP,n =10).They were given intravenous fluid resuscitation according to Parkland formula 30 minutes after burn.The hemodynamics,organ functions and mortality were observed in conscious state before burn injury,and 2,6,8,12,24 hours after burn injury.Results Within 24 hours after burn,all the dogs in NR group died,and those in RL and RP groups were all alive.At 2 hours after burn,the mean arterial pressure (MAP),cardiac index (CI),dp/dt max of left ventricular contractility were significantly reduced in NR,RL and RP groups compared with those before injury [MAP(mmHg,1 mmHg =0.133 kPa):45.33 ± 7.78 vs.141.67 ± 5.98,91.33 ± 10.25 vs.142.33 ± 6.16,98.67 ± 9.54 vs.142.83 ±5.47; CI (mL·s-1·m-2):8.17 ±0.83 vs.48.34 ±3.33,16.84 ±2.17 vs.47.34 ± 1.67,19.00 ± 1.50 vs.47.34 ± 1.33; dp/dt max (mmHg/s):426.83 ± 51.91 vs.1 372.50 ± 39.61,594.00 ± 88.23 vs.1 363.83 ± 44.92,645.00 ±66.82 vs.1 395.83 ± 19.49,all P＜0.05],and the systemic vascular resistance (SVR) and alanine transaminase (ALT),creatinine (Cr),serum MB isoenzyme of creatine kinase (CK-MB),diamine oxidase (DAO) were significantly higher [SVR (kPa·s ·L-1):1 322.50 ±36.37 vs.281.45 ± 8.84,777.50 ±41.84 vs.289.72 ± 6.70,571.40 ±40.01 vs.286.27 ±8.66; ALT (U/L):89.50 ±4.11 vs.40.57 ±3.63,89.25 ±4.88 vs.37.92 ± 2.62,86.30 ±5.61 vs.38.47 ±3.50; Cr (μmol/L):75.62 ±4.61 vs.41.58 ±2.78,77.00 ±5.92 vs.46.55 ± 3.17,74.13 ±2.56 vs.45.65 ± 1.83; CK-MB (kU/L):13.122 ±0.282 vs.1.557 ±0.009,8.885 ±0.272 vs.1.497 ± 0.009,8.692 ± 0.180 vs.1.490 ± 0.005; DAO (kU/L):2.26 ± 0.14 vs.0.25 ± 0.02,1.50 ± 0.07 vs.0.25 ± 0.01,1.37 ± 0.07 vs.0.25 ± 0.02,all P＜0.05].All parameters in NR group kept on worsening till death,while hemodynamic and organ functions of two intravenous resuscitation groups were gradually improved,CI,SVR and DAO in RP group were significantly superior to those of RL group from 2 hours on after burn (all P＜0.05),and dp/dt max and CK-MB in RP group were significantly better than those of RL group from 6 hours on after burn [dp/dt max (mmHg/s):1 082.33 ± 63.59 vs.1 018.60 ± 47.36,CK-MB (U/L):7 898.70 ± 255.74 vs.8 438.70 ± 442.00,all P＜0.05],and MAP (mmHg) was significantly better than that of RL group at 6 hours (124.67 ± 9.39 vs.114.33 ± 9.16,P＜0.05),and Cr (tμmol/L) was significantly better than that of RL group from 24 hours on after burn (53.42 ± 4.99 vs.60.77 ± 3.11,P＜0.05).Conclusion The Pyr Ringer solution was superior to the Ringer lactate solution in improving hemodynamic and organ functions for intravenous resuscitation in dogs with 50％TBSA full thickness burn.
